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Biases in the healthcare luxury good hypothesis?: a meta‐regression analysis

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  • Joan Costa‐Font
  • Marin Gemmill
  • Gloria Rubert

Abstract

While a growing literature examining the relationship between income and health expenditures suggests that health care is a luxury good, this conclusion is contentiously debated due to heterogeneity of the existing results. This paper tests the luxury good hypothesis using meta-regression analysis, taking into consideration publication selection, precision, and aggregation bias. The findings suggest that publication bias exists, a result that is robust irrespectively of the tests employed. Precision and aggregation bias also appear to play a role in the generation of estimates. The corrected income elasticity estimates range from 0.26 to 0.84, although we cannot reject the luxury good hypothesis for some of the performed corrections.
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  • Joan Costa‐Font & Marin Gemmill & Gloria Rubert, 2011. "Biases in the healthcare luxury good hypothesis?: a meta‐regression analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 174(1), pages 95-107, January.
    • Handle: RePEc:bla:jorssa:v:174:y:2011:i:1:p:95-107
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    File URL: http://hdl.handle.net/10.1111/j.1467-985X.2010.00653.x
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    1. David Cantarero, 2005. "Decentralization and health care expenditure: the Spanish case," Applied Economics Letters, Taylor & Francis Journals, vol. 12(15), pages 963-966.
    2. T. D. Stanley & Stephen B. Jarrell, 2005. "Meta‐Regression Analysis: A Quantitative Method of Literature Surveys," Journal of Economic Surveys, Wiley Blackwell, vol. 19(3), pages 299-308, July.
    3. Marin C. Gemmill & Joan Costa‐Font & Alistair McGuire, 2007. "In search of a corrected prescription drug Elasticity estimate: a meta‐regression approach," Health Economics, John Wiley & Sons, Ltd., vol. 16(6), pages 627-643, June.
    4. McCoskey, Suzanne K. & Selden, Thomas M., 1998. "Health care expenditures and GDP: panel data unit root test results," Journal of Health Economics, Elsevier, vol. 17(3), pages 369-376, June.
    5. Theo Hitiris & John Nixon, 2001. "Convergence of health care expenditure in the EU countries," Applied Economics Letters, Taylor & Francis Journals, vol. 8(4), pages 223-228.
    6. Gerdtham, Ulf-G. & Lothgren, Mickael, 2000. "On stationarity and cointegration of international health expenditure and GDP," Journal of Health Economics, Elsevier, vol. 19(4), pages 461-475, July.
    7. Clemente, Jesus & Marcuello, Carmen & Montanes, Antonio & Pueyo, Fernando, 2004. "On the international stability of health care expenditure functions: are government and private functions similar?," Journal of Health Economics, Elsevier, vol. 23(3), pages 589-613, May.
    8. George Karatzas, 2000. "On the determination of the US aggregate health care expenditure," Applied Economics, Taylor & Francis Journals, vol. 32(9), pages 1085-1099.
    9. Getzen, Thomas E. & Poullier, Jean-Pierre, 1992. "International health spending forecasts: Concepts and evaluation," Social Science & Medicine, Elsevier, vol. 34(9), pages 1057-1068, May.
    10. Parkin, David & McGuire, Alistair & Yule, Brian, 1987. "Aggregate health care expenditures and national income : Is health care a luxury good?," Journal of Health Economics, Elsevier, vol. 6(2), pages 109-127, June.
    11. Ulf‐G. Gerdtham, 1992. "Pooling international health care expenditure data," Health Economics, John Wiley & Sons, Ltd., vol. 1(4), pages 217-231, December.
    12. Edward L. Glaeser & Bruce I. Sacerdote & Jose A. Scheinkman, 2003. "The Social Multiplier," Journal of the European Economic Association, MIT Press, vol. 1(2-3), pages 345-353, 04/05.
    13. Stanley, T. D. & Doucouliagos, Chris, 2007. "Identifying and correcting publication selection bias in the efficiency-wage literature: Heckman Meta-Regression," Working Papers eco_2007_11, Deakin University, Department of Economics.
    14. Edward L. Glaeser & Bruce Sacerdote, 2007. "Aggregation Reversals and the Social Formation of Beliefs," NBER Working Papers 13031, National Bureau of Economic Research, Inc.
    15. T. D. Stanley, 2008. "Meta‐Regression Methods for Detecting and Estimating Empirical Effects in the Presence of Publication Selection," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 70(1), pages 103-127, February.
    16. Joseph P. Newhouse, 1977. "Medical-Care Expenditure: A Cross-National Survey," Journal of Human Resources, University of Wisconsin Press, vol. 12(1), pages 115-125.
    17. Albert Okunade & Chutima Suraratdecha, 2000. "Health care expenditure inertia in the OECD countries: A heterogeneous analysis," Health Care Management Science, Springer, vol. 3(1), pages 31-42, January.
    18. Okunade, Albert A. & Murthy, Vasudeva N. R., 2002. "Technology as a 'major driver' of health care costs: a cointegration analysis of the Newhouse conjecture," Journal of Health Economics, Elsevier, vol. 21(1), pages 147-159, January.
    19. Joan Costa‐Font & Jordi Pons‐Novell, 2007. "Public health expenditure and spatial interactions in a decentralized national health system," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 291-306, March.
    20. Gerdtham, Ulf-G. & Jonsson, Bengt, 1991. "Conversion factor instability in international comparisons of health care expenditure," Journal of Health Economics, Elsevier, vol. 10(2), pages 227-234, July.
    21. Helmut Herwartz & Bernd Theilen, 2003. "The determinants of health care expenditure: testing pooling restrictions in small samples," Health Economics, John Wiley & Sons, Ltd., vol. 12(2), pages 113-124, February.
    22. Getzen, Thomas E., 2000. "Health care is an individual necessity and a national luxury: applying multilevel decision models to the analysis of health care expenditures," Journal of Health Economics, Elsevier, vol. 19(2), pages 259-270, March.
    23. T. D. Stanley, 2005. "Beyond Publication Bias," Journal of Economic Surveys, Wiley Blackwell, vol. 19(3), pages 309-345, July.
    24. Newhouse, Joseph P., 1987. "Cross national differences in health spending what do they mean?," Journal of Health Economics, Elsevier, vol. 6(2), pages 159-162, June.
    25. Dino Falaschetti, 2005. "Aggregate Health Expenditures, National Income, And Institutions For Private Property," Economics and Politics, Wiley Blackwell, vol. 17(3), pages 393-431, November.
    26. Theo Hitiris, 1997. "Health care expenditure and integration in the countries of the European Union," Applied Economics, Taylor & Francis Journals, vol. 29(1), pages 1-6.
    27. Levaggi, Rosella & Zanola, Roberto, 2003. "Flypaper Effect and Sluggishness: Evidence from Regional Health Expenditure in Italy," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 10(5), pages 535-547, September.
    28. Margherita Giannoni & Theodore Hitiris, 2002. "The regional impact of health care expenditure: the case of Italy," Applied Economics, Taylor & Francis Journals, vol. 34(14), pages 1829-1836.
    29. Hansen, Paul & King, Alan, 1996. "The determinants of health care expenditure: A cointegration approach," Journal of Health Economics, Elsevier, vol. 15(1), pages 127-137, February.
    30. Gerdtham, Ulf-G. & Jonsson, Bengt, 2000. "International comparisons of health expenditure: Theory, data and econometric analysis," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 1, pages 11-53, Elsevier.
    31. Colin J. Roberts, 2005. "Issues in Meta‐Regression Analysis: An Overview," Journal of Economic Surveys, Wiley Blackwell, vol. 19(3), pages 295-298, July.
    32. Nancy Devlin & Paul Hansen, 2001. "Health care spending and economic output: Granger causality," Applied Economics Letters, Taylor & Francis Journals, vol. 8(8), pages 561-564.
    33. Pedro Pita Barros, 1998. "The black box of health care expenditure growth determinants," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 533-544, September.
    34. Jennifer Roberts, 2000. "Spurious regression problems in the determinants of health care expenditure: a comment on Hitiris (1997)," Applied Economics Letters, Taylor & Francis Journals, vol. 7(5), pages 279-283.
    35. Anindya Sen, 2005. "Is Health Care a Luxury? New Evidence from OECD Data," International Journal of Health Economics and Management, Springer, vol. 5(2), pages 147-164, June.
    36. N.R. Murthy & Albert Okunade, 2000. "Managed care, deficit financing, and aggregate health care expenditure in the United States: A cointegration analysis," Health Care Management Science, Springer, vol. 3(4), pages 279-285, September.
    37. Gerdtham, Ulf-G. & Sogaard, Jes & Andersson, Fredrik & Jonsson, Bengt, 1992. "An econometric analysis of health care expenditure: A cross-section study of the OECD countries," Journal of Health Economics, Elsevier, vol. 11(1), pages 63-84, May.
    38. Donald Freeman, 2003. "Is health care a necessity or a luxury? Pooled estimates of income elasticity from US state-level data," Applied Economics, Taylor & Francis Journals, vol. 35(5), pages 495-502.
    39. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
    40. Vatter, Adrian & Rüefli, Christian, 2003. "Do Political Factors Matter for Health Care Expenditure? A Comparative Study of Swiss Cantons," Journal of Public Policy, Cambridge University Press, vol. 23(3), pages 301-323, September.
    41. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    42. Jewell, Todd & Lee, Junsoo & Tieslau, Margie & Strazicich, Mark C., 2003. "Stationarity of health expenditures and GDP: evidence from panel unit root tests with heterogeneous structural breaks," Journal of Health Economics, Elsevier, vol. 22(2), pages 313-323, March.
    43. Blomqvist, A. G. & Carter, R. A. L., 1997. "Is health care really a luxury?," Journal of Health Economics, Elsevier, vol. 16(2), pages 207-229, April.
    44. Di Matteo, Livio & Di Matteo, Rosanna, 1998. "Evidence on the determinants of Canadian provincial government health expenditures: 1965-1991," Journal of Health Economics, Elsevier, vol. 17(2), pages 211-228, April.
    45. T. D. Stanley, 2001. "Wheat from Chaff: Meta-analysis as Quantitative Literature Review," Journal of Economic Perspectives, American Economic Association, vol. 15(3), pages 131-150, Summer.
    46. Luca Crivelli & Massimo Filippini & Ilaria Mosca, 2006. "Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 535-541, May.
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    More about this item

    Keywords

    Aggregate health expenditure ; Healthcare ; Income elasticity ; Luxury goods ; Meta‐regression analysis ; Regional health expenditure ;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I10 - Health, Education, and Welfare - - Health - - - General

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